the thoughts of a surgeon in the notorious province of mpumalanga, south africa. comments on the private and state sector. but mostly my personal journey through surgery.

Tuesday, February 09, 2010

crushing

we can sometimes look good in our jobs. i suppose it comes with the territory. but sometimes this is not a good thing.

danville is an interesting place. actually the place itself is drab but it is full of interesting people. to say it is populated by the lower echelons of the gene pool is an understatement of note. for some reason every reprobate and inbreed seems to have found their way there. throw a few generations of fetal alcohol syndrome into the mix and you have the average danville resident. then add a strong predilection to grandpa (a local aspirin caffeine headache powder) to round off with. usually when they presented to the hospital it is usually with a bleeding peptic ulcer or a perforated peptic ulcer. in fact they seldom present to us with anything else.

she was a typical danville special. she lay there on the bed holding her abdomen in pain. the sheets were stained with a dark coffee like substance from her last episode of vomiting and her face had taken on a complexion similar to the original colour of those same sheets. although she was about 50, she didn't look a day older than 65. her face was etched with the marks a pack a day of the finest tobacco for about 30 years will leave. she had also probably consumed a small country's fair share of brandy in her time. i groaned. all i could hope for was that she wouldn't end up going to theater because the operative risk for such a patient is high.

fortunately for her, and for me i might add, she responded very well to our conservative measures and it seemed like we would be able to avoid taking a knife to her. when i saw her later in the ward she had even regained some of the colour back in her cheeks. this was of course due to the blood we had given her, but i didn't mind. the fact was things were looking up.

her daughter was with her. it was clear they were family. if anything the genetic material had deteriorated somewhat passing from mother to daughter. as was typical of danville, her face looked about 45 although she was probably only 30 years old. the daughter stared at me with what i can only describe as a grimace on her face. even when i looked back at her she did not break her gaze. she was obviously unhappy with the treatment we were giving her mother i assumed. i wasn't particularly worried about her opinion in the matter so i just ignored her. i was just too happy that we were getting her mother better without subjecting her to surgery. i left as soon as i could.

the next day on academic rounds we discussed the usual causes of bleeding peptic ulcers. the prof even made mention of the fact that the ones from danville are almost always caused by grandpa use. he added that he was impressed we had managed to avoid theater. i knew i should be proud but during the whole conversation through the corner of my eye i could see the daughter sitting there staring at me with those accusing eyes. i had a feeling there was going to be a complaint laid against me, but for what i did not know. i had no idea what i had done that had incurred her wrath so.

the rounds went on and finally ended. i walked back to the doctor's tea room to organise and delegate the necessary ward work. as i went through the door leading to the balcony the daughter came from the other side. we almost collided. she smelt of the cheap cigarette she had just smoked. up close the deep crevices in her face could possibly have put the grand canyon to shame in complexity. her makeup was also wildly overdone, unless you believe eye shadow should be sky blue and lipstick should go over the lip and be applied half way to the nose too. i stared. i couldn't help it. it seems i have a tendency to be overcome with morbid fascination. she held my gaze, unflinchingly, despite the considerable weight of her fake eyelashes. then she spoke.

"doctor." i felt trapped. i could no longer ignore her. i had to answer.

"yes."

"can i ask you something?" as she spoke her false teeth floated up and down, completely separately to the movement of the rest of her mouth. again i found myself staring.

"yes." i lied.

"are you single?" what the hell??

"no."

"that's a pity because you are f#@king sexy."

i had to actively prevent myself from gagging. i'm convinced i ran as i left although i tried not to give the impression of a traumatised buck fleeing a horrible death at the hands of a leopard, albeit one that had tried to change its spots with too much makeup.

You always see(as you alluded) the classic lame gazelle at the back of the pack getting mauled by the attack cat; this is the lame attack cat trying to ask the healthy gazelle, "Will you just give up the chase for charity?" LOL

look just because i put my makeup on with a trowel doesnt mean i dont stand a chance. I went to watch Invictus last night. i shoved my fat feet into some tight white stiletoes, i put on my white pvc miniskirt and i could just tell that all south african men in the audience wanted to lick the varicous veins on the back of my knees. Anyhow the movie was o.k. but it was cold since i live in Aberdeen. Rubgy is a dangeraous game and should be banned anyhow

Still, every person in the world has a right to be judged purely for who they are. Absent of where they are from or the hard times they may have fallen upon or been born into. Was this a good person? That's really all that matters, it seems to me.

anonymous that asks me to use capitals. to be honest you asked so nicely that i actually considered trying. however i have a job that i do and do seriously. this is a hobby. if it becomes too much effort or too serious i might not enjoy it anymore.p.s quite a few people would say the fact that i am a surgeon proves i'm an idiot. thanks for noticing that i'm not illiterate.

last anonyomous, yes you are right. even danville has decent people. truth of the matter it is usually the bottom of the rung people who turned up with us anyway in state medicine. danville patients do have a grandpa problem in general though. but i suppose all generalizations are at least partly wrong, even this one.

i did judge her in that i thought she was being critical of how i treated her mother and in that i turned out to be wrong. as far as her looks are concerned, beauty may be in the eye of the beer holder, but i'd have to be a keg or two down before she became attractive to me. that opinion has nothing to do with her as a person, i think.

I appreciate your always thoughtful answers.And,yes (or should that be a no?),I wasn't responding to whether you should have found her attractive or not. That is certainly one hundred percent your personal matter.Thanks for doing this blog; it's fascinating and so excellently written.

Bongi,As much as I believe in the truth of my original comment, I think I was very unjust in posting it as a comment to YOU. I greatly admire the work you do.Please feel free to remove my posts."last anonymous"

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disclaimer

the aim of this blog is to give insight into the mind of a particular surgeon, me. although every story is loosely based on fact, patients have been changed suitably to protect their identity. the opinions expressed are mine alone and are not meant to be considered medical advice or the opinion of any institution.